Top 231 Auditor Jobs in Garden Grove, Ca

Pharmacy Part D Auditor
Clever Care Health Plan —Huntington Beach, CA
- $80,000 - $90,000 a year
- Full-time
- Hybrid work
- Background check
- Bachelor of Science
- Mid-level
Risk Adjustment Coding Auditor
Clever Care Health Plan —Huntington Beach, CA
- $72,800 - $80,000 a year
- Full-time
- Hybrid work
- Background check
- Nursing
- Microsoft Excel
AUDITOR I
Department of Health Care Services —Orange County, CA
- $4,256 - $5,600 a month
- Multiple hires
- Hybrid work
- Microsoft Word
- Microsoft Excel
- Writing skills
- Paid holidays
- Dental insurance
10d
Accountant
OCTA —Orange, CA
- $40.06 - $55.11 an hour
- Full-time
- Mid-level
- Office
- 3 years
14d
Auditor
Kia Motors America —Irvine, CA
- $63,669.83 - $82,795.83 a year
- Dealership
- Mid-level
- 3 years
- Paid holidays
- Health insurance
9d
Internal Auditor
Memorial Health Services —Fountain Valley, CA
- $26.48 - $38.40 an hour
- Full-time
- HIPAA
- Mid-level
- Bachelor's degree
- Health insurance
9d
Auditor/Investigator I
Qlarant —Los Alamitos, CA
- $47,911 - $71,508 a year
- Full-time
- Analysis skills
- Bachelor's degree
- Entry level
Quick Apply
Auditor/Investigator II
Qlarant —Los Alamitos, CA
- $57,512 - $85,839 a year
- Full-time
- Mid-level
- Analysis skills
- Bachelor's degree
Quick Apply
Remote Medicare Risk Adjustment Coding/ Auditor (Prior CMS-HCC V28 required)
Alignment Healthcare USA, LLC —Orange, CA
- $64,384 - $96,577 a year
- Full-time
- Remote
- Microsoft Outlook
- Basic math
- HIPAA
Quick Apply
1d
Audit & Assurance Senior - Pricing & Profitability CoE
Deloitte —Costa Mesa, CA
- $72,900 - $149,700 a year
- Full-time
- Research
- Finance
- Analysis skills
8d
Assurance Services Associate (Government)
The Pun Group, LLP —Santa Ana, CA
- $70,000 - $73,000 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- CPA
- Health savings account
- Paid holidays
Quick Apply
11d
Senior Auditor
University of California, Irvine —Irvine, CA
- $81,600 - $147,800 a year
- Full-time
- Background check
- 3 years
- University
- Health insurance
- Retirement plan
Audit Associate - 50%+ Work from Home
Conrad LLP —Lake Forest, CA
- $60,000 - $65,000 a year
- Full-time
- Hybrid work
- Background check
- Bachelor of Science
- Travel
- Disability insurance
- Health insurance
Staff Accountant
ViewSonic Corporation —Brea, CA
- Hybrid work
- Oracle
- Mid-level
- Office
- Health insurance
- Dental insurance
Accountant I
MEXICAN AMERICAN OPPORTUNITY FOUNDATION —Montebello, CA
- $77,000 - $78,000 a year
- Full-time
- Mid-level
- Office
- Analysis skills
- Paid jury duty
- 403(b) matching
Finance Manager (Mandarin-Speaking)
Reproductive Fertility Center —Corona, CA
- From $75,000 a year
- Full-time
- CPA
- Clinic experience
- Finance
- Disability insurance
- Health insurance
Quick Apply
Audit Partner
ZH CPA LLC —Irvine, CA
- Full-time
- Hybrid work
- CPA
- 11+ years
- Continuous improvement
Quick Apply
11d
Staff Accountant
Confidential —Chino, CA
- $32 - $36 an hour
- Full-time
- Microsoft Word
- Microsoft Excel
- Customer service
- Health insurance
- Dental insurance
Quick Apply
CPA FIRM - Senior/ Tax Manager
Accounting Firm —City of Industry, CA
- $22 - $38 an hour
- 8 hour shift
- Management
- CPA
- Research
- Health insurance
- Dental insurance
Quick Apply
Call Center Quality Assurance Auditor
United Faith Ministries Inc —Orange, CA
- $26 an hour
- Full-time
- Spanish
- HIPAA
- English
- 403(b) matching
- Health insurance
Quick Apply

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Pharmacy Part D Auditor

Clever Care Health Plan -
Huntington Beach, CA

Apply Now

Job Details

Full-time
$80,000 - $90,000 a year

Qualifications

Regulatory compliance evaluation
Medicare
CMS
CMS regulatory compliance
Bachelor's degree
Medicare regulations
Medication therapy management (MTM)

Full Job Description

This position operates on a hybrid work schedule. Candidate must reside in Los Angeles or Orange County.

Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.

Who Are We? ✨

Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values.

Why Join Us?

We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation.

Job Summary

The Pharmacy Part D Oversight Auditor owns independent auditing and monitoring of Part D clinical compliance: CDAG (coverage determinations, exceptions, redeterminations), MTM program elements (targeting, CMR/TMR), and delegated PBM controls; ensures timeliness, accuracy, and member impact remediation are documented and audit-ready.

Functions & Job Responsibilities

Audit coverage determinations and redeterminations timeliness, notice content, exceptions processing, and effectuation under Part 423 Subpart M.
Validate MTM targeting criteria, Comprehensive and Targeted Medication Review (CMR/TMR) completion, and annual CMS submission/attestation compliance under §423.153 and current year guidance.
Monitor delegated PBM and pharmacy FDRs for adherence to plan policy and CMS requirements; track corrective actions consistent with delegation oversight duties.
Coordinate with UM/Part C on benefit coordination issues (e.g., B vs D drug coverage boundaries) affecting member access and appeals.
Prepare CDAG/MTM dashboards and Board-level reporting

Required Qualifications

Bachelor of Science in Pharmacy
3–5+ years Part D operations/compliance auditing.
Proficiency with 42 C.F.R. Part 423 Subparts D & M and current MTM expectations

Deep knowledge of:

CMS Program Audit (CDAG, FA, CPE)
Delegation oversight principles and evidence requirements
Part D regulatory structure and operational requirements

Preferred Qualifications

PharmD or Registered Pharmacist (RPh) preferred
SNP experience strongly preferred

Wage Range: $80,000 to $90,000 per year

Physical & Working Environment.

Physical requirements needed to perform the essential functions of the job, with or without reasonable accommodation:

Must be able to travel when needed or required
Ability to operate a keyboard, mouse, phone and perform repetitive motion (keyboard); writing (note-taking)
Ability to sit for long periods; stand, sit, reach, bend, lift up to fifteen (15) lbs.

Ability to express or exchange ideas to impart information to the public and to convey detailed instructions to staff accurately and quickly.

Work is performed in an office environment and/or remotely. The job involves frequent contact with staff and the public. May occasionally be required to work irregular hours based on the needs of the business.

Leadership Expectations

By way of leadership approach, mobilize others to create extraordinary results, and unite people to turn challenges into successes by championing the following:

1. Model the Way:

Clarify values by finding your voice and affirming shared values
Set the example by aligning actions with shared values

2. Inspire a Shared Vision

Envision the future by imagining exciting and ennobling possibilities
Enlist others in a common vision by appealing to shared aspirations

3. Challenge the Process

Search for opportunities by seizing the initiative and looking outward for innovative ways to improve
Experiment and take risks by consistently generating small wins and learning from experience

4. Enable Others to Act

Foster collaboration by building trust and facilitating relationships
Strengthen others by increasing self-determination and developing competence

5. Encourage the Heart

Recognize contributions by showing appreciation for individual excellence
Celebrate the values and victories by creating a spirit of community

Clever Care Health Plan is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

Salary ranges posted on the job posting are based on California wages. Salary may be higher or lower depending on the candidate’s state residency.

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Refine Your Search

auditor jobs in garden grove, ca

Pharmacy Part D Auditor

Risk Adjustment Coding Auditor

AUDITOR I

Accountant

Auditor

Internal Auditor

Auditor/Investigator I

Auditor/Investigator II

Remote Medicare Risk Adjustment Coding/ Auditor (Prior CMS-HCC V28 required)

Audit & Assurance Senior - Pricing & Profitability CoE

Assurance Services Associate (Government)

Senior Auditor

Audit Associate - 50%+ Work from Home

Staff Accountant

Accountant I

Finance Manager (Mandarin-Speaking)

Audit Partner

Staff Accountant

CPA FIRM - Senior/ Tax Manager

Call Center Quality Assurance Auditor

I want to receive the latest job alert for auditor in garden grove, ca

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